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The nurse is providing education at a senior center. Which of the following measures will the nurse say is most effective in attaining normal blood pressure in a client with hypertension?
- A. eating red meat daily
- B. increasing potassium and calcium intake
- C. increasing fluid intake
- D. decreasing sodium intake
Correct Answer: D
Rationale: Decreasing sodium intake is the most effective dietary measure to manage hypertension, as sodium increases blood pressure. Red meat (A) may worsen it, potassium/calcium (B) is supportive but less impactful, and fluid intake (C) is not directly related.
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The nurse is caring for a client who is a survivor of a disaster event. The client begins to display behaviors not demonstrated before. Which manifestations should indicate to the nurse that the client may be experiencing post-traumatic stress disorder (PTSD)? Select all that apply.
- A. Irritability and sleep disturbances
- B. Flashbacks or recollections of the disaster
- C. Regression to an earlier developmental stage
- D. A feeling of estrangement or detachment from others
- E. Consistent discussion and rationalizing as to why the disaster occurred
- F. Repression or the inability to remember an important aspect associated with the disaster
Correct Answer: A,B,D,F
Rationale: PTSD involves recurrent flashbacks, irritability, sleep disturbances, estrangement, and repression of trauma-related memories. Regression and rationalizing the event's cause are not typical PTSD symptoms. These manifestations indicate a sustained maladaptive response to the traumatic event, often with avoidance of trauma-related stimuli and psychological distress.
The nurse is giving a client with chronic obstructive pulmonary disease (COPD) information related to the positions used to breathe more easily. The nurse teaches the client to assume which position?
- A. Sit bolt upright in bed with the arms crossed over the chest.
- B. Lie on the side with the head of the bed at a 45-degree angle.
- C. Sit in a reclining chair tilted slightly back with the feet elevated.
- D. Sit on the edge of the bed with the arms leaning on an overbed table.
Correct Answer: D
Rationale: Proper positioning can decrease episodes of dyspnea in a client with COPD. Appropriate positions include sitting upright while leaning on an overbed table, sitting upright in a chair with the arms resting on the knees, and leaning against a wall while standing. Sitting bolt upright with arms folded across the chest restricts the movement of the anterior and posterior walls of the lung, and side-lying with the head of bed raised to a 45-degree position restricts the expansion of the lateral wall of the lung. Option 3 restricts posterior lung expansion.
A client is newly diagnosed with chronic obstructive pulmonary disease (COPD). The client returns home after a short hospitalization. The home care nurse should most importantly plan teaching strategies that are designed to do what?
- A. Promote membership in support groups.
- B. Encourage the client to become a more active person.
- C. Identify irritants in the home that interfere with breathing.
- D. Improve oxygenation and minimize carbon dioxide retention.
Correct Answer: D
Rationale: Chronic obstructive pulmonary disease (COPD) is a disease state characterized by airflow obstruction. Improving oxygenation and minimizing carbon dioxide retention are the primary goals. The other options are interventions that will help with the achievement of this primary goal.
The nurse is planning to teach a teenage client about sexuality. What should the nurse do first?
- A. Inform the teenager about the dangers of pregnancy.
- B. Establish a relationship and determine prior knowledge.
- C. Advise the teenager to maintain sexual abstinence until marriage.
- D. Provide written information about sexually transmitted infections.
Correct Answer: B
Rationale: The first step in effective communication is establishing a relationship. By exploring the client's interest and prior knowledge, rapport is established, and learning needs are assessed. The other options may or may not be later steps, depending on the data obtained.
The nurse is teaching a client diagnosed with histoplasmosis infection about the prevention of future exposure to infectious sources. The nurse determines that the client needs further instruction if the client states that which is a potential source of this infection?
- A. Grape arbors
- B. Bird droppings
- C. Mushroom cellars
- D. Floors of chicken houses
Correct Answer: A
Rationale: Grape arbors do not harbor the causative organism for histoplasmosis. The client diagnosed with histoplasmosis is taught to avoid exposure to potential sources of the fungus, including bird droppings (especially those of starlings and blackbirds), mushroom cellars, and the floors of chicken houses and bat caves.